Sick Building Syndrome (SBS) is a worldwide and complex problem. SBS initially was used to describe a building where a set of varied symptoms were experienced predominantly by people working in an
air conditioned environment.

Subsequent early study by Finnegan and others has shown that SBS is not limited to air conditioned facilities and can, in fact, be observed in naturally ventilated buildings. More recent joint research in England by British architect Alexi Marmot and her husband Michael, an epidemiology professor, concludes complex SBS involvement with the occupant’s home environment, poor facility management, and worker satisfaction.

A syndrome, by definition, is a group of signs and symptoms that occur together and characterize a particular abnormality. Frequently they form an identifiable pattern. This makes diagnosis by exclusion possible. For example, organic lesions are not associated with SBS. If an occupant has persistent organic lesions, it can be assumed that the cause of the sickness is not SBS.

A building is said to be “sick,” when 20 percent or more of the occupants voluntarily complain of discomfort symptoms for periods exceeding two weeks, and affected occupants obtain rapid relief away from the building. The 20 percent figure is an arbitrary level derived from earlier ASHRAE efforts to define comfort.

This acceptability level, when transferred to the IAQ arena as a level of temperature acceptability, may mislead managers who look to “20 percent” as a guideline for action. A knowledgeable investigator would ask, “If you have 3,000 employees and only 10 percent are ill, do you wait?

That’s 300 people who could be suffering needlessly from a pollutant in the work place.” A problem closely associated to SBS is building related illness (BRI). Medical diagnosis can identify specific health effects that result in known disease etiology, such as Legionnaire’s disease, that are a direct result of building conditions.

Once diagnosed, a BRI can help identify the source contaminants and may reveal ways to remedy the situation. A BRI facility has almost always passed through the SBS stage and usually still has other contributing contaminants or causes at work. The five symptom complexes associated with SBS are discussed below; followed by the major building related illnesses.